Side-firing fiber delivery device with active cooling cap

ABSTRACT

A medical laser system and related methods of utilizing cooling within and around an optical fiber tip to prevent premature failure of the optical fiber. The optical fiber is surrounded by protective jacket assembly including a body tube assembly and a tip cap assembly. The body tube assembly includes an internal fiber jacket and an external body tube with a body tube channel defined therebetween. The tip cap assembly includes an inner cap member and an outer cap member defining a cap irrigation channel therebetween. Together, the cap irrigation channel and body tube channel cooperatively define an internal irrigation channel. The optical fiber can be delivered to a treatment location through a cystoscope. Saline is directed through an external irrigation channel between the cystoscope and the protective jacket assembly as well as the internal irrigation channel to cool the fiber tip and prevent overheating and failure of the optical fiber.

PRIORITY CLAIM

The present application claims priority to U.S. Provisional ApplicationSerial No. 60/953,721 filed Aug. 3, 2007, and entitled “Side-FiringFiber Delivery Device with Active Cooling Cap”, which is herebyincorporated by reference in its entirety.

FIELD OF THE INVENTION

This invention relates to the field of medical lasers utilizing opticalfibers. More specifically, the present invention relates to aside-firing optical fiber utilizing internal and external coolingstreams to prevent premature failure at a fiber tip.

BACKGROUND OF THE INVENTION

Medical lasers have been used in treatment procedures involving variouspractice areas, including, for example, urology, neurology,otorhinolaryngology, general anesthetic ophthalmology, dentistry,gastroenterology, cardiology, gynecology, and thoracic and orthopedicprocedures. Generally, these procedures require precisely controlleddelivery of laser energy, and often the area to which the laser energyis to be delivered is located deep within the body; for example, at theprostate or at the fallopian tubes. Due to the location of the targettissue deep within the body, the medical procedure requires that theoptical fiber be flexible and maneuverable. Various light sources can beused with optical fiber devices dependent upon the requirements for thelight source; for example, pulsed lasers, diode lasers and neodymiumlasers can be used as light sources. Representative lasers used inmedical treatment procedures include Ho:YAG lasers and Nd:YAG lasers.

In medical procedures utilizing laser energy, the laser is coupled to anoptical fiber adapted to direct laser radiation from the laser, throughthe fiber and to the treatment area. Typically, a surgical probe isutilized in the treatment of body tissue with laser energy. The surgicalprobe generally includes an optical fiber coupled to a laser source, andthe probe tip is positioned on the optical fiber opposite the lasersource, such that the tip of the probe can be positioned adjacent to thetargeted tissue. Laser energy is directed out of the probe tip of theoptical fiber onto desired portions of the targeted tissue.

Depending upon the operational conditions during laser treatment, a capon the surgical probe can overheat. Overheating of the cap can lead tofailure of the optical fiber. If the optical fiber fails, the lasersystem fails. Overheating of the cap can cause the cap to burn, detach,or even shatter during treatment inside the patient, which can lead toinjury to the patient.

SUMMARY OF THE INVENTION

The present invention comprises a medical laser system and relatedmethods of utilizing cooling within and around an optical fiber tip soas to prevent premature failure of the optical fiber. The optical fibercomprises an internal fiber jacket having a fiber tip for directinglaser energy from the optical fiber. The optical fiber is generallysurrounded by a body tube and a tip cap assembly. The tip cap assemblygenerally comprises an inner cap member and an outer cap member. Theouter cap member includes a side port positioned within an exteriorsurface. An internal irrigating channel is defined between the inner capmember and the outer cap member. The optical fiber is generallyconfigured for insertion through a cystoscope such that the fiber tipcan be positioned proximate a treatment location. Once the fiber tip isproperly positioned, saline can be directed through the irrigatingchannel as well as between the cystoscope and the exterior surface tocool the optical fiber and prevent overheating and subsequent failure ofthe optical fiber. In addition, the use of the outer cap member providesa barrier between the fiber tip and treatment location so as to preventadhesion of ablated tissue to the fiber tip.

In one aspect, the present invention is directed to an optical fiberhaving a tip cap assembly defining an internal irrigation channel. Theoptical fiber can be configured for insertion into a cystoscope whereinsaline can be simultaneously directed through the internal irrigationchannel and between the cystocope and an exterior surface of the tip capassembly. By continually circulating saline both internally andexternally of the fiber tip, overheating of the fiber tip is preventedso as to prevent premature failure of the optical fiber.

In another aspect, the present invention is directed to a method forpreventing overheating of an optical fiber. The method comprisesproviding an optical fiber having an internal irrigation channel at afiber tip. The method further comprises circulating saline through theinternal irrigation channel to remove heat energy from the fiber tip.The method further comprises circulating a cooling saline between acystoscope and an exterior surface of the fiber tip. The method canfurther comprise providing a physical barrier between a dischargeportion of the optical fiber and the treatment location to preventadhesion of ablated tissue to the optical fiber.

In yet another aspect, the present invention is directed to a medicallaser treatment system comprising a laser unit and an optical fibercapable of being introduced to a treatment location with a cystoscope. Afiber tip of the optical fiber is capable of being cooled simultaneouslywith an external cooling stream between the cystoscope and protectivejacket assembly as well as through an internal irrigation channeldefined by a tip cap assembly.

The above summary of the various representative embodiments of theinvention is not intended to describe each illustrated embodiment orevery implementation of the invention. Rather, the embodiments arechosen and described so that others skilled in the art may appreciateand understand the principles and practices of the invention. Thefigures in the detailed description that follows more particularlyexemplify these embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

These as well as other objects and advantages of this invention, will bemore completely understood and appreciated by referring to the followingmore detailed description of the presently preferred exemplaryembodiments of the invention in conjunction with the accompanyingdrawings of which:

FIG. 1 is a block diagram illustration of a laser system according to anembodiment of the present invention.

FIG. 2 is a perspective end view of an optical fiber according to anembodiment of the present invention.

FIG. 3 is a section view of the optical fiber of FIG. 2.

FIG. 4 is a section view of the optical fiber of FIG. 2 being introducedto a treatment location with a cystoscope according to an embodiment ofthe present invention.

FIG. 5 is a graph comparing percentage of transmission of a opticalfiber (2090 fiber) to an optical fiber with active cooling cap of thepresent invention.

While the invention is amenable to various modifications and alternativeforms, specifics thereof have been shown by way of example in thedrawings and will be described in detail. It should be understood,however, that the intention is not to limit the invention to theparticular embodiments described. On the contrary, the intention is tocover all modifications, equivalents, and alternatives.

DETAILED DESCRIPTION OF THE DRAWINGS

The present invention comprises an optical fiber for use with a medicallaser system that utilizes internal and external cooling streams andrelated methods of monitoring an optical fibers to determine if anoptical fiber cap on the optical fiber is in imminent danger of capfailure. The laser system includes a photodetector for convertingreturned light from the optical fiber cap to an electronic signal forcomparison to a trigger threshold value known to be indicative imminentfiber cap failure. The returned light can be the main laser treatmentwavelength, an auxiliary wavelength such as an aiming beam or infraredwavelengths generated by a temperature of the optical fiber cap. In theevent the electronic signal reaches the trigger threshold value, thelaser system can be temporarily shut-off or the power output can bereduced. In one preferred embodiment, the present invention can beutilized as part of a Greenlight HPS system manufactured by AmericanMedical Systems of Minnetonka, Minn. and as described in U.S. Pat. Nos.6,554,824 and 6,986,764, which are herein incorporated by reference.

Referring to FIG. 1, there is depicted a block diagram showing anexemplary laser system 100 which may be employed for implementing thepresent invention. Laser system 100 includes a solid-state laser unit102, which is used to generate laser light for delivery through opticalfiber 106 to target tissue 104. Laser unit 102 is capable of beingoperated in a pulsed mode or continuous wave.

Laser unit 102 more specifically comprises a laser element assembly 110,pump source 112, and frequency doubling crystal 122. In thepreferred-embodiment, laser element 110 outputs 1064 nm light which isfocused into frequency doubling crystal 122 to create 532 nm light.According to one implementation, laser element assembly 110 may beneodymium doped YAG (Nd:YAG) crystal, which emits light having awavelength of 1064 nm (infrared light) when excited by pump source 112.Laser element 110 may alternatively be fabricated from any suitablematerial wherein transition and lanthanide metal ions are disposedwithin a crystalline host (such as YAG, Lithium Yttrium Fluoride,Sapphire, Alexandrite, Spinel, Yttrium Orthoaluminate, PotassiumGadolinium Tungstate, Yttrium Orthovandate, or Lanthahum ScandiumBorate). Laser element 110 is positioned proximal to pump source 112 andmay be arranged in parallel relation therewith, although othergeometries and configurations may be employed.

Pump source 112 may be any device or apparatus operable to excite laserelement assembly 110. Non-limiting examples of devices which may be usedas pump source 112, include: arc lamps, flashlamps, and laser diodes.

A Q-switch 114 disposed within laser unit 102 may be operated in arepetitive mode to cause a train of micropulses to be generated by laserunit 102. Typically the micropulses are less than 1 microsecond induration separated by about 40 microseconds, creating a quasi-continuouswave train. Q-switch 114 is preferably of the acousto-optic type, butmay alternatively comprise a mechanical device such as a rotating prismor aperture, an electro-optical device, or a saturable absorber.

Laser unit 102 is provided with a control system 116 for controlling andoperating laser unit 102. Control system 116 will typically include acontrol processor which receives input from user controls (including butnot limited to a beam on/off control, a beam power control, and a pulseduration control) and processes the input to accordingly generate outputsignals for adjusting characteristics of the output beam to match theuser inputted values or conditions. With respect to pulse durationadjustment, control system 116 applies an output signal to a powersupply (not shown) driving pump source 112 which modulates the energysupplied thereto, in turn controlling the pulse duration of the outputbeam. Laser unit 102 further includes an output port 118 couplable to aproximal end 119 of optical fiber 106. Output port 118 directs the lightgenerated by laser unit 102 into optical fiber 106 for delivery totissue 104.

Although FIG. 1 shows an internal frequency doubled laser, it is only byway of example. The infrared light can be internally or externallyfrequency doubled using non-linear crystals such as KTP, LithiumTriborate (LBO), or Beta Barium Borate (BBO) to produce 532 nm light.The frequency doubled, shorter wavelength light is better absorbed bythe hemoglobin and char tissue, and promotes more efficient tissueablation.

Referring now to FIGS. 2 and 3, optical fiber 200 of the presentinvention generally comprises an internal fiber 202 defining a fiber tip204 at a treatment end 206 of the optical fiber 200. Internal fiber 202is manufactured from a silicon material, typical of optical fibers.Internal fiber 202 is protected from damage prior to use and duringintroduction to the treatment location with a protective jacket assembly206. Projective jacket assembly 206 generally comprises a body tubeassembly 208 and a tip cap assembly 210. Body tube assembly 208generally protects a majority portion of the internal fiber 202,extending from proximal end 119 to the tip cap assembly 210. Body tubeassembly 208 generally comprise an internal fiber jacket 212 and anexternal body tube 214 with a body tube channel 216 definedtherebetween. Similar to internal fiber 202, internal fiber jacket 212and external body tube 214 are constructed of a suitable siliconmaterial.

As illustrated in FIG. 3, tip cap assembly 128 generally comprises aninner cap member 218 and an outer cap member 220 defining a capirrigation channel 222 therebetween. Together, cap irrigation channel222 and body tube channel 216 cooperatively define an internalirrigation channel 224. Outer cap member 220 includes a side port 226positioned within an exterior surface 228. Side port 226 generallydefines a radiused edge 230 such that laser energy can be directed fromthe fiber tip 204 to the treatment location.

In operation, optical fiber 200 and more specifically fiber tip 204 canbe introduced to the treatment location utilizing a conventionalcystoscope 240 as shown in FIG. 4. Generally, the cystoscope 240 isadvanced through the urethra and proximate the treatment area. Once thecystoscope 240 is positioned at the treatment area, an irrigant such aswater or saline can be injected through the cystoscope 240. Whenperforming a medical laser procedure with the laser system 100, opticalfiber 200 is advanced through the cystoscope 240 such that side port 226is positioned proximate the desired treatment location.

With the side port 226 oriented toward the treatment location, saline issimultaneously directed through the internal irrigation channel 224 andin an external irrigation channel 242 defined between the cystoscope 240and the protective jacket assembly 206. With an external cooling stream244 flowing across exterior surface 228 and between the inner cap member218 and an internal cooling stream 246 flowing between the outer capmember 220, control system 116 directs laser energy through the opticalfiber 200 such that a treatment beam exits the fiber tip 204 and out theside port 226. As the treatment beam contacts the treatment location,heat is generated at a tissue surface as the laser energy ablates thetargeted tissue. The dual simultaneous cooling of the external coolingstream 244 and the internal cooling stream 246 remove heat energy fromthe fiber tip 204. As fiber tip 204 is prevented from overheating,ablated tissue is kept from adhering within or around the side port 226or to the exterior surface 228. In addition, the outer cap member 220provides a gap between the fiber tip 204 and the treatment location suchthat tissue does not attach to the fiber tip 204 due to localizedheating at the fiber tip 204. With heat energy removed at the tip capassembly 210, overheating is avoided such that devitrification andcratering of optical fiber 200 does not occur.

FIG. 5 provides a comparison between the standard 2090 fiber that istypically used with a GreenLight HPS laser treatment device fortreatment of benign prostate hyperplasia (BPH) and the fiber with activecooling cap of the present invention. As shown the percentage oftransmission of light stays steady in the fiber with the active coolingcap while the 2090 fiber experiences intermittent decreases intransmission of light as energy is increased. As indicated by the graph,the active cooling cap fiber of the present invention provides reducedlaser energy absorption by preventing the tissue contact at the laserfiring point and the areas adjacent to the firing point; the tissue isin contact with the outer cap rather than the inner cap through whichthe laser light is being delivered. Further, the irrigation fluid fromthe about the inner cap pushes the tissue debris out of the firing pointof the inner cap and, hence, further prevents tissue debris fromdepositing and burning at the firing point. Moreover, the active coolingcap of the present invention can provide cooling from inside of the capeven when the irrigation fluid from the cystoscope is totally block bytissue.

Although specific examples have been illustrated and described herein,it will be appreciated by those of ordinary skill in the art that anyarrangement calculated to achieve the same purpose could be substitutedfor the specific examples shown. This application is intended to coveadaptations or variations of the present subject matter. Therefore, itis intended that the invention be defined by the attached claims andtheir legal equivalents.

We claim:
 1. An optical fiber for medical procedures comprising: aninternal fiber terminating at a fiber tip, the internal fiber beingsurrounded by a body tube assembly at a proximal portion of the internalfiber and by a tip cap assembly at the fiber tip, the tip cap assemblyand body tube defining an internal irrigation channel for cooling thefiber tip during a medical laser procedure.
 2. The optical fiber ofclaim 1, wherein the tip cap assembly comprises an inner cap member andan outer cap member, a cap irrigation channel being defined between theinner cap member and the outer cap member.
 3. The optical fiber of claim2, wherein the body tube assembly comprises an internal fiber jacket andan external body tube, a body tube channel being defined between theinternal body tube and the external body tube, and wherein the capirrigation channel and the body tube channel cooperatively define theinternal irrigation channel.
 4. The optical fiber of claim 2, whereinthe outer cap member includes an exterior surface having a side-firingport for directing laser energy from the fiber tip to a treatmentlocation.
 5. The optical fiber of claim 4, wherein the outer cap memberprovides a physical barrier preventing contact between the fiber tip andthe treatment location during a treatment procedure.
 6. The opticalfiber of claim 1, wherein the body tube assembly and tip cap assemblyare adapted for introduction through a cystoscope, whereupon an internalsaline flow can be directed through the internal irrigation channel andan external saline flow can be directed between the cystoscope and thebody tube assembly and tip cap assembly to simultaneously cool the fibertip.
 7. A method for preventing overheating a medical optical fiberduring a medical treatment procedure comprising: providing an opticalfiber having an internal fiber jacket surrounding by a protective jacketassembly, wherein an internal irrigation channel is defined between theinternal fiber jacket and the protective jacket assembly; directing aninternal saline flow stream through the internal irrigation channel; andremoving heat energy generated at a fiber tip during treatment with theinternal saline flow stream.
 8. The method of claim 7, furthercomprising: accessing an internal treatment site with a cystoscope; andadvancing the optical fiber through the cystoscope such that the fibertip is proximate the internal treatment site.
 9. The method of claim 8,further comprising: directing an external saline flow stream through agap defined between the cystoscope and the protective jacket assembly.10. The method of claim 7, wherein the protective jacket assemblycomprise a tip cap assembly proximate the fiber tip, the tip capassembly including an inner cap member and an outer cap member, whereinthe internal irrigation channel is defined between the inner cap memberand the outer cap member.
 11. The method of claim 10, furthercomprising: directing laser energy from the fiber tip through aside-firing port in the outer cap member.
 12. The method of claim 11,further comprising: preventing adhesion of ablated tissue to the fibertip by maintaining a physical gap between the fiber tip and a treatmentsite.
 13. A medical laser system comprising: a laser unit for generatinglaser treatment energy; and an optical fiber attached to the laser unitfor directing the laser treatment energy to a treatment location, theoptical fiber including an internal fiber jacket surrounding by aprotective jacket assembly such that an internal irrigation channel isdefined between the internal fiber jacket and the protective jacketassembly such that an internal saline flow can be directed through theinternal irrigation channel to cool a fiber tip on the optical fiber.14. The medical laser system of claim 13, further comprising: acystoscope for accessing a treatment site within the patients body, theoptical fiber adapted for insertion through the cystoscope such that anexternal saline flow can be directed between the cystoscope and theprotective jacket assembly.
 15. The medical laser system of claim 13,wherein the external fiber jacket comprises a body tube assembly at aproximal portion of the internal fiber jacket and a tip cap assembly atthe fiber tip.
 16. The medical laser system of claim 15, wherein the tipcap assembly comprises an outer cap member and an inner cap member, theouter cap member including an exterior surface having a side-firing portfor directing laser energy from the fiber tip to the treatment location.17. The medical laser system of claim 16, wherein the outer cap memberprovides a physical barrier preventing contact between the fiber tip andthe treatment location during a treatment procedure.